Health: State vs Ability to Adapt

Defining the term ‘health’ seems to boil down to two general camps. One, in the spirit of the World Health Organization’s 1948 description: “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity”, (Huber, 2011, p.235), restricts the definition to a nearly -if not entirely- unachievable state whereby the many factors that contribute to well-being are all maximized simultaneously (Leonardi, 2018 pp.736-737). This not only draws a black and white line between health and illness, but the term ‘complete’ in this definition also suggests that all shades of grey would land on the ‘illness’ side of that delineation. The strict nature of this definition represents an issue akin to a hamster wheel -try as one may, all the most advanced medical interventions, social assistance and emotional counselling will fall short in achieving the illusive state of ‘health’ for much of the population.

An alternative approach is to define health as an ability to overcome or improve in the face of challenges. Leonardi (2018) proposes: “the capability to react to all kinds of environmental events having the desired emotional, cognitive, and behavioral responses and avoiding those undesirable ones” (p.742) as a modern definition. This gives an individual, in consultation with medical professionals, the latitude to set realistic targets given their unique biological and psychological limitations (Bradley, Goetz, & Viswanathan, 2018, p.205). Such a definition accounts for the reality that most will never achieve a perfect score in all contributing factors along the health-illness continuum at any one time. Rather than accepting a defeated outlook and giving up on the notion of health altogether on one side, or striving endlessly to further optimize a perhaps adequate level of wellness on the other, this definition promotes the maintenance of a level of wellness that is individualized.

To arrive at a consensus on the subject, one must decide what purpose they wish for a definition of health to serve. If it is to set a universal standard toward which the medical community must strive, the WHO definition will suffice. One must recognize, however, that this will be out of reach for the entire life of the majority, and for the later years of all (Caplan, 2015, p.1). If optimizing the wellness of each individual is the ultimate goal, the ‘ability to adapt’ fits the role. This would require individualized attention from physicians and other primary care providers and extensive communication with healthcare consumers to set realistic goals that they may then work together to reach or maintain. Furthermore, these standards would require reassessment as contributing factors change.

Defining any term is a tricky proposition. Words, in any language are typically created out of necessity; to categorize a thing, feeling or idea in a way that limits confusion. Like any word, ‘health’ was originally coined to fill this void in a specific capacity. Over time, the scope of medicine, psychology and sociology are bound to dictate a shift in some manner with this particular definition. Political interests in controlling healthcare expenditures will likely also figure into this evolution as governments work to build fiscally responsible healthcare frameworks. By accepting Leonardi (2018, p. 742)’s definition, populations would be better served as citizens would receive more personalized care and healthcare providers would waste less time chasing nirvana when realistic satisfaction may be the best many can hope to achieve.

References

Bradley, K. L., Goetz, T., & Viswanathan, S. (2018). Toward a Contemporary Definition of Health. MILITARY MEDICINE, 183, 204–207. https://doi.org/10.1093/milmed/usy213

Caplan, A. (2015). How Can Aging Be Thought of as Anything Other Than a Disease? In Handbook of the Philosophy of Medicine (pp. 1–8). https://doi.org/10.1007/978-94-017-8706-2_10-1

Huber, M. (2011). HEALTH: HOW SHOULD WE DEFINE IT? In Medical Journal (Vol. 343). Retrieved from https://0-www-jstor-org.aupac.lib.athabascau.ca/stable/pdf/23051314.pdf?refreqid=excelsior%3A1e602715da178276805b81625174d804

Leonardi, F. (2018). The Definition of Health: Towards New Perspectives. International Journal of Health Services, 48(4), 735–748. https://doi.org/10.1177/0020731418782653